I woke in a panic and gasped for a deep breath, but the air that swirled around my constricted body was humid and dense. Trying to remain calm, I took several slow and methodical breaths while my wheezing lungs broke the stillness inside the dark bedroom. Oxygen passed into my respiratory system like it was travelling through a tiny, plastic straw, yet it was enough for me to relax slightly and try to untangle my thoughts and surroundings.
It was the middle of the night, and outside my window, monsoon showers pounded the countryside of Varkala, a coastal town in the south-western state of Kerala, India, that overlooks the Arabian Sea. With its lush and tropical rainforests, backwater lagoons and verdant hillsides covered in tea plants, Kerala is often called ‘God’s Own Country’ by locals, and its landscapes were unlike any part of India I had seen so far.
I had arrived two days earlier with my husband, and our plan was to relax here before a hiking trek into the Western Ghats mountain range. But right now, that seemed entirely out of reach. I thought about waking Richard from his jet-lagged slumber, but there was nothing he could do. Because, after all, I knew what was going on.
View image of Writer Ryan MacDonald experienced an asthma attack while visiting Varkala in the south-west Indian state of Kerala (Credit: Credit: Anders Blomqvist/Getty Images)
At the age of four, I was diagnosed with allergy-induced asthma, a condition triggered by various environmental factors, like the dander of fluffy cats or the heaviness of second-hand cigarette smoke. By the age of 10, I was signed up for the local aquatics team because my paediatrician informed my mother that lap swimming would make my lungs stronger. Learning how to wear Speedos confidently may have taken me years, but I never experienced those terrifying attacks again.
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Until now. I knew that a massive asthma attack had flared up, likely caused by the poor air quality in Mumbai, where we had spent the first few days of our trip exploring the city underneath its charcoal-coloured skies. While there, I turned our hotel bathroom into a sweat lodge and inhaled the steam from our shower; a remedy that often did the trick. But here I was, the furthest away I had ever been from home, suffering through one of the worst health scares in my adult life. I thought I had outgrown this condition. Sure, there had been occasional flare-ups during my teenage years when I’d return from playing outside on a smoggy afternoon and have a few puffs from an inhaler. As an adult, doctors continued to write me prescriptions, but more as a precaution than a life-saving measure.
Unable to think straight, my mind jumped to hypothetical questions and worst-case scenarios. Like, why hadn’t I packed an old inhaler? Or, better yet, why didn’t I ask my doctor for a new prescription? If things got worse, who would we call?
I had to get through the night, so I shifted my focus and retraced the events of the past couple of days.
View image of Animal dander, smoke and smog can all trigger allergy-induced asthma attacks (Credit: Credit: ARUN SANKAR/Getty Images)
Our first night appeared from an ethereal dream. Richard and I walked along the yellow shores of Papanasam Beach with Deb, an expatriate from the United States who treated us like we were her own children when we arrived at her homestay. She paraded us into town, introduced us to her favourite shop owners and showed us which restaurants served the freshest fish. Down on the beach, she pointed out where local Hindu priests performed spiritual cleansings for family members who had recently lost loved ones. I watched these intimate interactions from a distance, as community elders scattered the ashes of the deceased and peered into the souls of those who were broken.
I wondered about my grandmother, who’d unexpectedly passed away three days earlier when we arrived in India, and whether she was at peace. Too shy to ask for a session myself, I made friends with the local stray dogs instead. Smoke from bundles of incense drifted into the evening sky as we left the beach and walked back to Deb’s home. I thought of all the people who made the pilgrimage to this holy resting place, and how someday we’d all return to ash.
I had to get through the night
The next morning, we woke to a breakfast of crispy fried vadas, a savoury doughnut-like pastry I had never had before, and spicy green curry with lentils served family-style in large bowls. Deb shared stories from her travels, and told me about her enormous collection of artwork and antiques that were displayed throughout the house. I could sense how much love she put into the details, and how deeply she cared for the visitors who entered her peaceful sanctuary.
Richard and I passed that afternoon at an outdoor cafe, sipping cups of cardamom coffee as rain showers arrived. When the clouds parted, I ventured to the beach once again and hurdled over choppy waves until I had the courage to dunk myself under the ocean’s surface. The waters near Papanasam Beach are said to purify your soul and wash away your sins. I declared this a baptism to keep me safe on my journey, and dove into an oncoming wave.
View image of Hindu priests at Papanasam Beach offer spiritual cleansings for those who recently lost loved ones (Credit: Credit: Frank Bienewald/Getty Images)
This carousel of joyful memories quickly faded away back in the darkness of our bedroom. For the next few hours, I wrestled into various positions on my back, like an upside beetle searching for the ground, wheezing through breath after exhausting breath. Every so often, Richard rolled over to see how I was doing. My lungs were getting worse.
By 06:00, I resigned myself to seeking help from a doctor – not an easy choice for someone who prefers to tough things out. Even as a child when my attacks were frequent, I never went to the emergency room, and before this, the worst health scare that I had ever experienced while travelling abroad was a case of Montezuma’s revenge.
I felt vulnerable admitting that my body was broken
The truth was, I felt vulnerable admitting that my body was broken, and there was no part of me that wanted to visit a foreign hospital – a place that conjured up nightmarish images where things could go very wrong, very fast. I fully understood this fear seemed like an ignorant belief, but I clung to it stubbornly. However, it was my negligence that landed me here, I also reasoned, and the circumstances I faced required an acceptance of things I could not change.
I found Deb on the rooftop veranda enjoying her morning coffee. “Are you OK?” she said with a maternal urgency.
“I think… I need… to go the hospital,” I stammered, pausing between each phrase. The simplest of sentences took all my breath and energy, and I had very little of each. “I’m having… a hard time… breathing.”
Deb set a plan in motion while Richard grabbed our belongings in case my condition didn’t improve. Before long, I was gripping the railing inside a rickshaw on my way to the emergency room. In the back seat of this wobbly, motorised tricycle, Richard, Deb and I slid across the plastic seat covering with every curve in the road. Maybe because I was on my way to receive help or because I had wanted to ride in one of these tuk-tuks since arriving in India, but my mood lifted unexpectedly. No longer consumed with the fear of dying, I was in the company of the living.
View image of The waters near Papanasam Beach are said to purify your soul (Credit: Credit: zhouyousifang/Getty Images)
At the hospital, I was taken through a swinging door to a room with stretchers, empty mattresses and a slow-moving ceiling fan that circulated the stagnant air. There were bottles of medicine in cabinets and a plastic glove dispenser. This room was no different than any other hospital I had entered. This is what I had been so afraid of, I wondered? Now those thoughts all seemed so silly.
A nurse came in and asked me a few preliminary questions while she strapped an oxygen mask around my face. Almost immediately, steroids opened the depths of my lungs. Air hadn’t reached those pockets in hours, and my body (and brain) relaxed. Under the glow of the fluorescent lighting, I felt as though I was taking my first breath in life, just like being born again.
I felt as though I was taking my first breath in life
By the time a doctor came to check on me 30 minutes later, the fear from the night before had completely vanished. Her bedside manner put me at ease and she introduced herself as Mya, a name that reminded me of home and my mum’s dog. She told me to continue resting and that I could be released in another hour. Everything was OK, she said.
She handed me a prescription and my bill. With my brain still not fully functioning, I couldn’t calculate the currency difference and had no idea how much this whole fiasco cost. Richard looked over my shoulder. “It’s only $20,” he said in disbelief. I studied the bill and tried to add the itemised numbers, convinced there was an error. But everything added up.
“Oh my God,” Richard proclaimed. I thought he finally caught a mistake in calculation. “Look at your doctor’s name!”
I studied the piece of paper, and saw it on the last line: ‘Dr Casualty’. I looked at Richard and we burst out laughing.
View image of After suffering an asthma attack, MacDonald and his husband completed a hike in the Western Ghats mountain range (Credit: Credit: Ryan MacDonald)
As we were dropped off at home, Deb instructed the same tuk-tuk driver to head to the chemist and fill my prescription. Without hesitation, he followed her directions, and soon handed me a paper bag stuffed with pill bottles that would last the remainder of our trip. I barely knew this man’s name, yet he had raced me to the emergency room, waited patiently outside for two hours and helped save my life.
Deb told us that we could stay a few extra days because she didn’t have any visitors arriving for another week, but Richard and I chose to say our goodbyes. There was more of this great, big country for us to see, and Deb understood that desire to keep moving. I hugged her like I do my own mother when I leave home, and promised to email in a few days.
Twenty-four hours later, I stood on the edge of a cliff overlooking a deep valley near Munnar, a mountainous expanse that sits 1,600m above the sea. Clouds drifted through thickets of tall grass. I stretched my arms wide, trying to grab hold of the fog, but it passed right through me. Far below, a sinuous road carved through the emerald landscape, like a single ribbon wrapped around a present. My lungs were still tender, but at this elevation, the air felt thin and clean, moving into my body with ease.
View image of Ryan MacDonald: “There was more of this great, big country for us to see” (Credit: Credit: Ryan MacDonald)
I was taking it easy along this 11km trek into the Western Ghats, where we passed tea workers carrying bulky sacks of tealeaf clippings over their shoulders and then followed the treks of elephants that roamed outside Eravikulam National Park.
Communing with nature always brings me closer to myself, providing a moment to reflect and return to a sense of inner wholeness. But given what I faced a day earlier, I felt more connected to my surroundings and the people I had encountered on my path: Deb; my tuk-tuk driver; Dr Casualty. Without them, I thought, would I be seeing these mountains at all? Would I even be here in this moment?
I grounded myself in the natural world around me and then continued hiking, one cautious step at a time.
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